[Federal Register Volume 76, Number 165 (Thursday, August 25, 2011)]
[Notices]
[Pages 53137-53138]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-21707]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-5504-N]
Bundled Payments for Care Improvement Initiative: Request for
Applications
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
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SUMMARY: This notice announces a request for applications for
organizations to participate in one or more of the initial four models
under the Bundled Payments for Care Improvement initiative beginning in
2012.
DATES: Letter of Intent Submission Deadlines: Interested organizations
must submit a nonbinding letter of intent by September 22, 2011 for
Model 1 and November 4, 2011 for Models 2 through 4 as described on the
CMS Innovation Center Web site http://www.innovations.cms.gov/areas-of-focus/patient-care-models/bundled-payments-for-care-improvement.html.
For applicants wishing to receive historical Medicare claims data in
preparation for Models 2 through 4, a separate research request packet
and data use agreement must be filed in conjunction with the Letter of
Intent.
Application Submission Deadlines: Applications must be received on
or before October 21, 2011 for Model 1 and March 15, 2012 for Models 2
through 4.
ADDRESSES: Letter of Intents and Applications should be submitted
electronically in searchable PDF format via encrypted e-mail to the
following e-mail address by the date specified in the DATES section of
this notice: [email protected]. Applications and appendices
will only be accepted via e-mail.
FOR FURTHER INFORMATION CONTACT: [email protected] for
questions regarding the application process of the Bundled Payments for
Care Improvement initiative.
SUPPLEMENTARY INFORMATION:
I. Background
We are committed to achieving the three-part aim of better health,
better health care, and reduced expenditures through continuous
improvement for Medicare, Medicaid and Children's Health Insurance
Program (CHIP) beneficiaries. Beneficiaries can experience improved
health outcomes and patient experience when health care providers work
in a coordinated and patient-centered manner. To this end, we are
interested in partnering with providers who are working to redesign
patient care to deliver these aims. Episode payment approaches that
reward providers who take accountability for the three-part aim at the
level of individual patient care for an episode are potential
mechanisms for developing these partnerships.
In order to provide a flexible and far-reaching approach towards
episode-based care improvement, we are seeking proposals from health
care providers who wish to align incentives between hospitals,
physicians, and nonphysician practitioners in order to better
coordinate care throughout an episode of care. This Bundled Payment for
Care Improvement initiative request for applications (RFA) will test
episode-based payment for acute care and associated post-acute care,
using both retrospective and prospective bundled payment methods. The
RFA requests applications to test models centered around acute care;
these models will inform the design of future models, including care
improvement for chronic conditions. For more details, see the RFA which
is available on the Innovation Center Web site at http://www.innovations.cms.gov/areas-of-focus/patient-care-models/bundled-payments-for-care-improvement.html.
II. Provisions of the Notice
Consistent with its authority under section 1115A of the Social
Security Act (of the Act), as added by section 3021 of the Affordable
Care Act, to test
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innovative payment and service delivery models that reduce spending
under Medicare, Medicaid, or CHIP, while preserving or enhancing the
quality of care, the Innovation Center aims to achieve the following
goals through implementation of the Bundled Payments for Care
Improvement initiative:
Improve care coordination, patient experience, and
accountability in a patient centered manner.
Support and encourage providers who are interested in
continuously reengineering care to deliver better care, better health,
at lower costs through continuous improvement.
Create a virtuous cycle that leads to continually
decreasing the cost of an acute or chronic episode of care while
fostering quality improvement.
Develop and test payment models that create extended
accountability for better care, better health at lower costs for acute
and chronic medical care.
Shorten the cycle time for adoption of evidence-based
care.
Create environments that stimulate rapid development of
new evidence-based knowledge.
The models to be tested based on applications to the RFA are as
follows:
Model 1: Retrospective payment models around the acute
inpatient hospital stay only.
Model 2: Retrospective bundled payment models for
hospitals, physicians, and post-acute providers for an episode of care
consisting of an inpatient hospital stay followed by post-acute care.
Model 3: Retrospective bundled payment models for post-
acute care where the episode does not include the acute inpatient
hospital stay.
Model 4: Prospectively administered bundled payment models
for the acute inpatient hospital stay only, such as prospective bundled
payment for hospitals and physicians for an inpatient hospital stay
Organizations are invited to submit proposals that define episodes
of care in one or more of these four models. Proposals should
demonstrate care improvement processes and enhancements such as
reengineered care pathways using evidence-based medicine, standardized
care using checklists, and care coordination. All models must encourage
close partnerships among all of the providers caring for patients
through the episode. Applicants must demonstrate robust quality
monitoring and protocols to ensure beneficiary quality protection.
Under all models, applicants must provide Medicare with a discount on
Medicare fee-for-service expenditures.
Bundled Payments for Care Improvement agreements will include a
performance period of 3 years, with the possibility of extending an
additional 2 years, beginning with the respective program date. The
program start date may be as early as the first quarter of CY 2012 for
awardees in Model 1.
III. Collection of Information Requirements
Section 1115A(d) of the Act waives the requirements of the
Paperwork Reduction Act of 1995 for the Innovation Center for purposes
of testing new payment and service delivery models.
Authority: 44 U.S.C. 3101.
Dated: August 17, 2011.
Donald M. Berwick,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2011-21707 Filed 8-23-11; 11:15 am]
BILLING CODE 4120-01-P